FFT: Risk and Protective Factors Directly Addressed By Phase,

And Major Techniques Utilized

James F Alexander, Ph.D

Functional Family Therapy LLC

March 12. 2009

Phase / Risk Factors Addressed / Protective Factors
Pre-
Intervention / Poor treatment system(s) linking, poor communication / Immediate availability of resources; positive referral, Responsive systems
Engagement / Family negative attitudes about treatment
Client perception of low therapist / agency credibility,
Difficult transportation issues;
Visible cues of “non-match,” “Competing” treatment systems involved; / Positive attitudes re treatment;
Therapist / agency convenience & availability (distance, hours);
Positive agency & program reputation in community,
Engagement / Therapist techniques > / Develop visible cues of cultural match; Strong reachout; Positive outreach to services already working with the family
Motivation / Hopelessness;
Low initial alliance;
Unbalanced alliance w/ therapist;
High negativity & blaming,
Negative attributions;
Attitude of the problem as “individual;”
Low within-family bonding / Balanced Alliance with therapist; Lower negativity & blame; Higher family bonding; Positivewithin family attributions; Hopeful attitude; Sense of “familyness;” Strong positive parent-child bond; Affection & respect;
Motivation / Therapist techniques > / Therapist relational skills (warmth, respectfulness);
Therapist Strength based relational focus w/ Change focus (pointing process, divert & interrupt, sequencing) & Change meaning (relabel, reframe, theme hints, behavioral and relational themes) techniques;
Behavior
Change / Low parenting involvement;
Poor parenting skills - unclear expectations, inadequate monitoring, inconsistent discipline patterns;
High marital discord;
Low intrafamily support;
Poor communication patterns & skills;, Youth history of non-compliance,
Poor self monitoring & impulse control; Behavioral expectations & demands are inconsistent with Relational Functions; Chaotic family environment;
Unresolved earlier abuse experiences; Mental health challenges in parent; Emotional disregulation;Maladaptive attributions; Syndrome-specific deficits including parent substance abuse / Positive parenting (clear expectations, monitoring in a manner that fits Relational Functions, appropriate rewards); Positive communication skills; Parent and youth negotiation skills, self-monitoring and self control (impulse) skills.
BC / Therapist techniques > / Syndrome-specific techniques (e.g., managing urges; anxiety reduction through redirection; avoid high-risk situations); Positive practice (emotional, behavioral, cognitive); Create & use of technical aids to support positive change; Therapist directing, prompting, role playing, cognitive and behavioral rehearsal, supporting, creating structure (Structuring skills); teach problem solving & communication skills
General-
ization / Parent substance abuse (if ongoing); Bonds w/ negative vs. positive peers; Poor social networks, Poor links with positive community resources;
Under- resourced parent(s);
Poor links with extended family;
Parental unemployment;
Peer rejection / Positive links with community resources (educational, vocational, medical, family support services & systems, positive peers) Generalization of developed skills; refusal skill training; Positive assertion and peer relationship skills;
Links to 12 step and other programs;
General-
ization / Therapist techniques > / Therapist in Family Case Manager role: Create / strengthen links with positive community resources (educational, vocational, medical, family support services & systems, positive peers); Relapse prevention; Youth (appropriate) assertion train’g